Failure to Provide Disposable Premoistened Cleansing Cloths for Residents with Wounds
Penalty
Summary
The facility failed to provide reasonable accommodation of resident needs and preferences by discontinuing the use of disposable premoistened cleansing cloths for four residents who had wounds or fragile skin. Despite informing residents and staff that these cloths could be provided for incontinent residents with wounds due to their softer texture, the facility did not make them available. Observations confirmed the absence of these wipes in the supply room, and multiple residents and staff reported that the facility had stopped supplying them, replacing them with dry disposable wipes or washable cloths that were described as rough, thin, and inadequate for care. Residents with wounds and fragile skin expressed dissatisfaction with the alternative products, stating that the dry wipes were not soft, tore easily, and left lint, while the washable cloths were rough and irritating. Some residents and their families resorted to purchasing the premoistened wipes themselves to meet care needs. The Resident Council President and the facility Ombudsman both confirmed that the discontinuation of the wipes had been a topic of concern among residents, with reports of postponed or interrupted care due to inadequate supplies. Medical record reviews for the affected residents showed that they had significant medical conditions, including wounds requiring daily care, diabetes, end-stage renal disease, and impaired mobility. Orders for wound care and skin treatments were documented, and residents were assessed as dependent on staff for hygiene and toileting. Despite these needs and the facility's policy to accommodate resident preferences unless it endangered health or safety, the facility did not provide the premoistened cleansing cloths as previously indicated.